Unknown Individual – Hematology & Oncology Physician, NPI 1073518742

Unknown Individual is a healthcare provider. based in Norfolk, Virginia. specializing in Hematology & Oncology Physician. They hold a License No. 0102026909 (VA). The NPI Number for Unknown Individual is 1073518742

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073518742
Phone
(757) 213-5700
Address
5900 LAKE WRIGHT DR
Deactivation Date
11 March 2021

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
7575390670
Graduation Year
1973 (53 years ago)
PAC ID
7719947993
Group Practice PAC ID
2769395797
Professional Enrollment ID
I20091109000483
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 5900, Lake Wright Drive, Camden Heights, Norfolk, Virginia, 23502, United States

    SUITE 300

    NORFOLK, VA 235021871

    Phone: (757) 213-5700

    Fax: (757) 213-5701

    Type: Mailing

  • 5838, Harbour View Boulevard, Harbour View, Belleville, Suffolk, Virginia, 23435, United States

    SUITE 105

    SUFFOLK, VA 234352663

    Phone: (757) 484-0215

    Fax: (757) 484-6792

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23502)

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Provider's Procedures

Unknown Individual performs procedures in Hematology & Oncology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
HEMATOLOGY/ONCOLOGYVA96367Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour19976
HEMATOLOGY/ONCOLOGYVA96375Injection of different drug or substance into a vein for therapy, diagnosis, or prevention9353
HEMATOLOGY/ONCOLOGYVA96415Infusion of chemotherapy into a vein3019

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769395797View full group profile
NameSpecialtyState
Physician AssistantCA
Physician AssistantVA
Nurse PractitionerNJ
Physician AssistantVA
-VA
Nurse PractitionerVA
-VA
H E M A T O L O G Y/ O N C O L O G YVA
Nurse PractitionerVA
Physician AssistantGA

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1073518742.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Hematology & Oncology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Norfolk, Virginia in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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